This project will develop evidence-based clinical guidelines and protocols to medically manage substance withdrawal in adults in jail-based settings.
The U.S. Department of Justice (DOJ) Bureau of Justice Assistance (BJA), in partnership with the National Institute of Corrections (NIC), seeks support in the development of evidence-based clinical guidelines and protocols that will help jail administrators, correctional officers, and jail-based clinicians identify and safely manage substance withdrawal in jail-based settings. The guidelines and protocols will address:
- Rapid withdrawal from opioids, benzodiazepines, alcohol, methamphetamine, and cocaine individually or in combination, including specification of persons who exhibit withdrawal symptoms or report histories or information from other sources that indicate the necessity of immediate referral to medical facilities outside of the jail.
- Screening for risk of suicide, specifically opioid withdrawal-potentiated suicides.
- Medication maintenance for entering detainees with prescriptions for opioid or antipsychotic medications.
- Transition to buprenorphine maintenance, or detoxification if the detainee prefers, especially for facilities that do not have access to an opioid treatment program for methadone maintenance.
- Standards for dosage and administration of agonist medication within the facility to patients who desire it after appropriate withdrawal management.
- Prescriptions upon release from custody, transition to care providers in the community, and record-sharing with those community treatment providers.
The clinical guidelines and protocols will be informed by best- and evidence-based medical practice, while accounting for the practical realities of medication-managed withdrawal in a correctional facility, including the need to prevent diversion. It will be further informed by legal analysis presented in a pending publication from Georgetown University that describes standards and implementation strategies for minimizing liability and negative outcomes in developing a comprehensive withdrawal management protocol.
The award recipient will complete the following major activities:
- Convene an expert committee to inform the development of the clinical guidelines.
- Conduct an environmental scan of existing guidelines for withdrawal management of opioids, benzodiazepines, alcohol, methamphetamine, and cocaine individually or in combination for adults (18 years and older), including special populations.
- Incorporate findings from the above two efforts to create a detailed content outline for the product.
- Produce draft- and final-version guidelines and protocols, which includes facilitating expert reviews.
Pursuant to the scope and nature of this project, applicants should demonstrate a deep understanding of correctional health care, addiction medicine, and jail administration, as well as extensive experience with medical standards and protocol development.
Under this solicitation, one applicant will be selected for a 10-month award to create a document (presented as a printable, 508-compliant PDF file) setting forth evidence-based clinical guidelines and protocols for medically managed withdrawal from opioids and other substances in jail-based settings for adults (individuals at least 18 years of age).
Period of Performance
The performance period is for 10 months, from November 23, 2020 to September 30, 2021.
Organizations, including but not limited to nonprofits and universities, that are committed to improving the standard of care in correctional facilities and can demonstrate a history of setting clinical standards around MAT and developing operational protocols within a correctional facility (or willing to partner) are eligible to apply for this award. The applicant organization must have the organizational capacity and project management capabilities to achieve the goals of the project. This must include the ability to convene an interdisciplinary expert advisory committee that represents key stakeholders, such as correctional health care, addiction medicine, and jail administration. The recipient and any subrecipient must forgo any profit or management fee.
Only one entity may serve as the award recipient. Any partnering entities must be proposed as subrecipients (subgrantees). The award recipient must be the entity that would have primary responsibility for carrying out the award, including administering the funding and managing the entire program.
Current COSSAP grantees, their contractors, and consultants are ineligible to apply for this award.
The Addressing Substance Use Disorders in America's Jails: Clinical Guidelines for Withdrawal Management application is available at https://www.cossapresources.org/Content/Documents/TTA/Addressing_SUD_in_Jails_Application_AHP.pdf.
Submit the completed application and required attachments by 5:00 p.m., ET, on October 28, 2020 to WithdrawalManagement_RFA@ahpnet.com.
Budget Detail Worksheet
The Budget Detail Worksheet is provided for your use in preparing the budget and budget narrative. All required information, including the budget narrative, must be provided. The Budget Detail Worksheet is available at https://www.cossapresources.org/Content/Documents/TTA/Budget_Detail_Worksheet_AHP.xlsx.
An informational webinar was held on October 5, 2020. A recording of the webinar is available at https://youtu.be/66Mg4pdKTFs. The corresponding slide deck that was used during the webinar can be viewed at http://s.iir.com/Slides_Webinar_AddressingSUDsInJailsRFA.
Frequently Asked Questions
A document containing answers to frequently asked questions about the Addressing Substance Use Disorders in America’s Jails: Clinical Guidelines for Withdrawal Management opportunity is available at https://www.cossapresources.org/Content/Documents/Funding/RFA_Q_and_A.pdf.
Advocates for Human Potential, Inc. (AHP), one of BJA’s Comprehensive Opioid, Stimulant and Substance Abuse Program (COSSAP) training and technical assistance providers, is releasing this solicitation on behalf of BJA/NIC. AHP will serve as the point of contact for the award recipient and will monitor all technical aspects of the contract, including contract administration. The AHP point of contact is Deann Jepson, firstname.lastname@example.org.